Provider Demographics
NPI:1255826897
Name:CAUGHMAN, THRESA (WHNP-BC)
Entity type:Individual
Prefix:
First Name:THRESA
Middle Name:
Last Name:CAUGHMAN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:THRESA
Other - Middle Name:A
Other - Last Name:HARGRAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2449 HOSPITAL DR STE 260
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-1909
Mailing Address - Country:US
Mailing Address - Phone:318-212-7840
Mailing Address - Fax:318-212-7845
Practice Address - Street 1:2449 HOSPITAL DR STE 260
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-1909
Practice Address - Country:US
Practice Address - Phone:318-212-7840
Practice Address - Fax:318-212-7845
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP10091363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health